Biased selection within the social health insurance market in Colombia

Las regulaciones como primaje comunitario, paquetes estandarizados y afiliación abierta, orientadas a reducir el impacto de las fallas en los mercados de seguros, tienen un efecto limitado puesto que abren espacio a la selección sesgada. A partir de 1993, el sistema de seguridad social en salud en Colombia fue reformado hacia un enfoque de mercado con la expectativa de mejorar el desempeño de los monopolios preexistentes exponiéndolos a la competencia de nuevos entrantes. La hipótesis que se maneja en el trabajo es que las fallas de mercado pueden llevar a selección sesgada favoreciendo a los nuevos entrantes. Se analizaron dos encuestas de hogares utilizando el estado de salud auto reportado y la presencia de enfermedad crónica como indicadores prospectivos del riesgo de los afiliados. Se encuentra que hay selección sesgada, llevando a selección adversa entre los aseguradores preexistentes, y a selección favorable entre los nuevos entrantes. Este patrón se observa en 1997 y se incrementa en el 2003. Aunque las entidades preexistentes son entidades públicas, y su tamaño disminuyó sustancialmente entre estos años, se analizan sus implicaciones fiscales en términos de financiación adicional por parte del gobierno.

Horizontal Inequity in Access to Health Care in Four South American Cities

The objective of this paper is compare socioeconomic inequalities in the use of healthcare services in four South-American cities: Buenos Aires, Santiago, Montevideo, and San Pablo. We use secondary data from SABE, a survey on Health, Well-being and Aging administered in 2000 underthe sponsorship of the Panamerican Health Organization, and representative of the elderly population in each of the analyzed cities. We construct concentration indices of access to and quality of healthcare services, and decompose them in socioeconomic, need, and non-need contributors. Weassess the weight of each contributor to the overall index and compare indices across cities. Our results show high levels of pro-rich socioeconomic inequities in the use of preventive services in all cities, inequities in medical visits in Santiago and Montevideo, and inequities in quality of access to care in all cities but Montevideo. Socioeconomic inequality within private or public health systems explains a higher portion of inequalities in access to care than the fragmented nature of health systems. Our results are informative given recent policies aimed at enforcing minimum packages of services and given policies exclusively focused on defragmenting health systems.

El entorno estadístico R : ventajas de su uso en la docencia y la investigación.

Resumen basado en el de la publicación

Tecnología de enseñanza individualizada con paquetes o unidades modulares de didáctica precorrectiva (reductora de fracaso escolar) para niveles de quinto y sexto de EGB en Ciencias Sociales.

Construir, evaluar, ensayar, comparar, aplicar y difundir los paquetes modulares de enseñanza individualizada (packages) de manera que se instalen en la enseñanza personalizada. Grupos de alumnos de quinto de EGB. Se pretende diseñar un experimento con 'unidades modulares de enseñanza', partiendo de unos supuestos y tratando de justificarlos de una manera teórica primero y posteriormente de una manera experimental. En este proceso se distinguen cuatro fases: una aproximación al campo de la investigación; un estudio de las bases para el sistema de unidades modulares de enseñanza; un análisis del marco general del experimento, como culminación de los contenidos teóricos del trabajo y un diseño experimental de unidades modulares de enseñanza, que permitió hacer funcionar dos ejemplos. Se confirma la hipótesis de partida con los resultados obtenidos en esta investigación. Los elementos integrados y sintetizados en los módulos de enseñanza consiguen más rendimiento en los aprendizajes que considerados en sí mismos por separado, sin complicar ni aumentar los costes y esto en diversos ambientes económicos y culturales, siendo factible para cualquier profesor en su aula. Como consecuencia de lo anterior, es posible hacer una síntesis superadora de las estructuras de la tecnología didáctica, a través de la didáctica modular, que genera 'módulos de aprendizaje' o, en un sentido más pragmático, 'las unidades modulares de enseñanza'.

Incongruence between test statistics and P values in medical papers

Given an observed test statistic and its degrees of freedom, one may compute the observed P value with most statistical packages. It is unknown to what extent test statistics and P values are congruent in published medical papers. Methods: We checked the congruence of statistical results reported in all the papers of volumes 409–412 of Nature (2001) and a random sample of 63 results from volumes 322–323 of BMJ (2001). We also tested whether the frequencies of the last digit of a sample of 610 test statistics deviated from a uniform distribution (i.e., equally probable digits).Results: 11.6% (21 of 181) and 11.1% (7 of 63) of the statistical results published in Nature and BMJ respectively during 2001 were incongruent, probably mostly due to rounding, transcription, or type-setting errors. At least one such error appeared in 38% and 25% of the papers of Nature and BMJ, respectively. In 12% of the cases, the significance level might change one or more orders of magnitude. The frequencies of the last digit of statistics deviated from the uniform distribution and suggested digit preference in rounding and reporting.Conclusions: this incongruence of test statistics and P values is another example that statistical practice is generally poor, even in the most renowned scientific journals, and that quality of papers should be more controlled and valued

Integration of knowledge-based, qualitative and numeric tools for real time dynamic systems supervision

The proposal presented in this thesis is to provide designers of knowledge based supervisory systems of dynamic systems with a framework to facilitate their tasks avoiding interface problems among tools, data flow and management. The approach is thought to be useful to both control and process engineers in assisting their tasks. The use of AI technologies to diagnose and perform control loops and, of course, assist process supervisory tasks such as fault detection and diagnose, are in the scope of this work. Special effort has been put in integration of tools for assisting expert supervisory systems design. With this aim the experience of Computer Aided Control Systems Design (CACSD) frameworks have been analysed and used to design a Computer Aided Supervisory Systems (CASSD) framework. In this sense, some basic facilities are required to be available in this proposed framework: ·

Moist singular vectors and the predictability of some high impact European cyclones

The ECMWF full-physics and dry singular vector (SV) packages, using a dry energy norm and a 1-day optimization time, are applied to four high impact European cyclones of recent years that were almost universally badly forecast in the short range. It is shown that these full-physics SVs are much more relevant to severe cyclonic development than those based on dry dynamics plus boundary layer alone. The crucial extra ingredient is the representation of large-scale latent heat release. The severe winter storms all have a long, nearly straight region of high baroclinicity stretching across the Atlantic towards Europe, with a tongue of very high moisture content on its equatorward flank. In each case some of the final-time top SV structures pick out the region of the actual storm. The initial structures were generally located in the mid- to low troposphere. Forecasts based on initial conditions perturbed by moist SVs with opposite signs and various amplitudes show the range of possible 1-day outcomes for reasonable magnitudes of forecast error. In each case one of the perturbation structures gave a forecast very much closer to the actual storm than the control forecast. Deductions are made about the predictability of high-impact extratropical cyclone events. Implications are drawn for the short-range forecast problem and suggestions made for one practicable way to approach short-range ensemble forecasting. Copyright © 2005 Royal Meteorological Society.

Participatory rural appraisal of dairy farms in the north west province of Cameroon

A Participatory Rural Appraisal (PRA) was conducted in dairy farms of the North West Province of Cameroon. The aim of the PRA was to have a better understanding of the prevailing dairy systems, identify problems, and set priorities for research and development that can contribute to improved systems of production. A multidisciplinary team of researchers and extension agents was constituted. It was made up of scientists of the following fields: cattle management, forage science, agro economy, veterinary, dairy technology, nutrition and extension. The research team visited farmers' groups and divided itself into subgroups for farm and village walks during which direct observations were also noted. The extension agent of the locality, key informants, gave additional information overlooked by farmers. Interviews were also carried out with other stakeholders of the dairy sector. The research team met the day following the visit to agree on a common report. Results show that five small scale dairy production systems are found in the region: transhumance, improved extensive, semi intensive, zero grazing and peri-urban. Agriculture is well integrated to dairying. Main constraints include in order of importance: poor marketing opportunities and long distances to market, limited grazing land and poor supplementation strategies, poor reproductive management and poor calving interval, inadequate knowledge in processing, hygiene and milk preservation, and limited health control. In market oriented farms, reproduction and feeding were the most important constraints. Main factors influencing dairy production are: milk collection, fresh milk price, consumer demand, genotype and management. These results suggest that much can be done to improve production by extending improved packages to dairy farmers.

Exploring the determinants of CAP reform: A Delphi survey of key decision-makers

A panel of key decision-makers, closely involved in the 1992, 1999 and 2003 CAP reforms, participated in a Delphi survey designed to ascertain what had prompted the European Commission to launch these reform initiatives and what factors were relevant in determining the reform packages subsequently decided by the Council.

Stock assessment for fishery management - A framework guide to the stock assessment tools of the Fisheries Management Science Programme (FMSP)

This document provides guidelines for fish stock assessment and fishery management using the software tools and other outputs developed by the United Kingdom's Department for International Development's Fisheries Management Science Programme (FMSP) from 1992 to 2004. It explains some key elements of the precautionary approach to fisheries management and outlines a range of alternative stock assessment approaches that can provide the information needed for such precautionary management. Four FMSP software tools, LFDA (Length Frequency Data Analysis), CEDA (Catch Effort Data Analysis), YIELD and ParFish (Participatory Fisheries Stock Assessment), are described with which intermediary parameters, performance indicators and reference points may be estimated. The document also contains examples of the assessment and management of multispecies fisheries, the use of Bayesian methodologies, the use of empirical modelling approaches for estimating yields and in analysing fishery systems, and the assessment and management of inland fisheries. It also provides a comparison of length- and age-based stock assessment methods. A CD-ROM with the FMSP software packages CEDA, LFDA, YIELD and ParFish is included.

The F test for comparing two normal variances: correct and incorrect calculation of the two-sided p-value?

This article illustrates that not all statistical software packages are correctly calculating a p-value for the classical F test comparison of two independent Normal variances. This is illustrated with a simple example, and the reasons why are discussed. Eight different software packages are considered.

Variance estimation with highly stratified sampling designs with unequal probabilities

It is common practice to design a survey with a large number of strata. However, in this case the usual techniques for variance estimation can be inaccurate. This paper proposes a variance estimator for estimators of totals. The method proposed can be implemented with standard statistical packages without any specific programming, as it involves simple techniques of estimation, such as regression fitting.

Variance estimation with Chao's sampling scheme

We show that the Hájek (Ann. Math Statist. (1964) 1491) variance estimator can be used to estimate the variance of the Horvitz–Thompson estimator when the Chao sampling scheme (Chao, Biometrika 69 (1982) 653) is implemented. This estimator is simple and can be implemented with any statistical packages. We consider a numerical and an analytic method to show that this estimator can be used. A series of simulations supports our findings.

HDC poinsettia tracker: flexible graphical tracking software

Growing pot poinsettia and similar crops involves careful crop monitoring and management to ensure that height specifications are met. Graphical tracking represents a target driven approach to decision support with simple interpretation. HDC (Horticultural Development Council) Poinsettia Tracker implements a graphical track based on the Generalised Logistic Curve, similar to that of other tracking packages. Any set of curve parameters can be used to track crop progress. However, graphical tracks must be expected to be site and cultivar specific. By providing a simple Curve fitting function, growers can easily develop their own site and variety specific ideal tracks based on past records with increasing quality as more seasons' data are added. (C) 2009 Elsevier B.V. All rights reserved.

Active-control trials with binary data: a comparison of methods for testing superiority or non-inferiority using the odds ratio

This paper considers methods for testing for superiority or non-inferiority in active-control trials with binary data, when the relative treatment effect is expressed as an odds ratio. Three asymptotic tests for the log-odds ratio based on the unconditional binary likelihood are presented, namely the likelihood ratio, Wald and score tests. All three tests can be implemented straightforwardly in standard statistical software packages, as can the corresponding confidence intervals. Simulations indicate that the three alternatives are similar in terms of the Type I error, with values close to the nominal level. However, when the non-inferiority margin becomes large, the score test slightly exceeds the nominal level. In general, the highest power is obtained from the score test, although all three tests are similar and the observed differences in power are not of practical importance. Copyright (C) 2007 John Wiley & Sons, Ltd.